Abstract
Although trends in health care point to the increasing involvement of the family in caring for the ill family member, little attention has been directed toward the needs of other healthy family members or the impact that cancer has on their lives. In this article, literature on the impact of cancer on the family will be reviewed and specific problems that family members confront over the course of the patient's illness will be identified. During the initial phase of cancer family members feel excluded from care, have difficulty communicating with staff and experience considerable emotional tension. In the adaptation phase family members have problems with lifestyle changes, meeting the needs of well family members and living with uncertainty. In the terminal phase family members experience role strain, communication problems on the subject of death and feelings of loss. Intervention strategies that have been used to assist family members to cope with the cancer experience are also reviewed. Finally, how past research on this topic has suffered from methodological problems, such as using a single spokesperson for the whole family, relying on subjects' long term recall and using only one data collection period for multiphase questions will be discussed. Directions for additional research are suggested.

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